Healthcare Consultant I (Hialeah and N. Miami Areas) FL area Job at SGS Consulting, Florida

RUpacHBWOGlWV1hmSms3SWI4VFNCR0pvZXc9PQ==
  • SGS Consulting
  • Florida

Job Description

Job Responsibilities:

  • Coordinates case management activities for Medicaid Long Term Care/Comprehensive Program enrollers.
  • Utilizes critical thinking and judgment to collaborate and inform the case management process, to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members using care management tools and resources.
  • Conducts comprehensive evaluation of Members using care management tools and information/data review
  • Coordinates and implements assigned care plan activities and monitors care plan progress
  • Conducts multidisciplinary review to achieve optimal outcomes
  • Identifies and escalates quality of care issues through established channels
  • Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs
  • Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health
  • Provides coaching, information and support to empower the members to make ongoing independent medical and/or healthy lifestyle choices
  • Help members actively and knowledgeably participate with their provider in healthcare decision-making
  • Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Skills:

  • Bilingual (Spanish, English) FLUENT speaking and writing
  • Case management experience required
  • Candidate will travel approximately 75% of the time within Miami-Dade County seeing members at their homes, in Assisted Living Facilities and Skilled Nursing Facilities

Education/Experience:

  • Bachelor's degree required - No nurses. Social work degree or related field.

Job Tags

Similar Jobs

Metra

Sr Project Manager, Telecom Job at Metra

 ...Northeastern Illinois by providing safe, reliable, and efficient commuter service. Engineering is responsible for building and maintaining the...  ..., and Communications and Maintenance. Reporting to the Manager of Telecommunications Design, the Sr Project Manager,... 

Ochsner Health

Nocturnist Physician - Hospitalist - Full-Time Academic Job at Ochsner Health

 ...Center - Shreveport seek applicants for an Academic Nocturnist/Hospitalist in the Department of Medicine. Ochsner LSU Health...  ...two in the state. Collegial and multidisciplinary team of physicians and nurses to collaborate on a customized plan of care for each... 

Gordon Food Service

Full Time - 2nd Shift Warehouse Package Handler Job at Gordon Food Service

 ...glance of who we are and the impact you could have on the food service industry. There's a seat at our table for you... 2nd Shift Warehouse Package Handler - Full Time Distribution Center Address: Springfield, OH Pay: Starting at $21.13/hour (includes a $1.00 2... 

Monocraft Private Limited

CNC Operator Job at Monocraft Private Limited

# Operate CNC lathe/milling machines as per job requirements. # Read and interpret technical drawings and work instructions. # Perform machine setup, tool loading, and zero-point setting. # Measure and inspect components using vernier, micrometer, and gauges. #... 

Manpower

Forklift Operator Job at Manpower

* Forklift Operators - Jamestown, NY - $17.00/hour - Minimum 2 year, on the job, forklift experience required!*** Join a growing company...  ...School Diploma or GED 2 years forklift experience 2 years warehouse environment experience Knowledge and experience in using...